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General NPI Number Information
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NPI Number | 1831741768
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Entity Type | Individual
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Provider Name | ROBERT BUTERA MD
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Gender | Male
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 3090 CARUSO CT STE 20
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City | ORLANDO
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State | FL
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Zip | 32806-8510
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Country | US
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Telephone | 321-841-5236
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Fax |
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Provider Business Mailing Address
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Address Line | 1414 KUHL AVE # MP31
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City | ORLANDO
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State | FL
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Zip | 32806-2008
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Country | US
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Telephone | 407-841-5133
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Fax | 407-237-6313
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | TRN29596
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME156164
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License Number State | FL
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